RESUMEN
The aim of this study was to estimate the prevalence of suspected head and neck cancer (HNC) diagnoses made by otolaryngologists in a population with subsequently confirmed cancer diagnoses in Germany. This study included patients with an initial documentation of confirmed cancer diagnosis made in 137 otolaryngology practices between January 2012 and December 2016 (index date). The main outcome of the study was the prevalence of diagnoses of suspected cancer in otolaryngology practices within one year prior to the first documentation of a confirmed cancer diagnosis. The association between the defined demographic and clinical variables with diagnoses of suspected cancer was analyzed using a logistic regression model. A total of 6,446 patients received a confirmed cancer diagnosis. A total of 23.1% of the population received a diagnosis of suspected cancer within 12 months prior to the first documentation of a confirmed cancer diagnosis. Patients over the age of 50 (ORs ranging from 1.44 to 1.55) and men (OR=1.52) were more likely to receive a diagnosis of suspected cancer compared with patients aged 50 or under and women. Cancer of the pyriform sinus (OR=3.00) and cancer of the thyroid gland (OR=0.27) were associated with increased and decreased odds of a diagnosis of suspected cancer compared to laryngeal cancer respectively. Overall, approximately 23% of individuals received a diagnosis of suspected cancer within a year prior to the first documentation of confirmed HNC.
RESUMEN
AIMS: Status epilepticus and seizure clusters are common neurological emergencies. The purpose of this monocentric, retrospective cohort study was to comparatively assess different antiepileptic approaches in the treatment of status epilepticus and seizure clusters, which were nonresponsive to benzodiazepines. METHODS: We reviewed medical records of 66 patients, who were treated for status epilepticus or seizure clusters in the Department of Neurology at the University of the Saarland between January 2007 and July 2012, and failed to respond to benzodiazepines with the equivalent dosage of at least 20 mg of diazepam. As endpoints, we analyzed both the effectiveness of lacosamide, levetiracetam, valproic acid, and phenytoin used as second- and third-line therapy, and the Glasgow Outcome Scale at day 7. RESULTS: Sixty-one (92.4%) of the patients had status epilepticus, and 5 (7.6%) had seizure clusters. The compared drugs were equally effective in terminating seizures. There was also no significant difference in the Glasgow Outcome Scale (P = 0.60) after 7 days. CONCLUSION: Our data support the use of the modern antiepileptic treatment strategies, such as levetiracetam, valproic acid, and lacosamide in the treatment of status epilepticus and seizure clusters.
